The oral health promotion team work within a range of settings to help maintain and improve the oral health of specific groups of people across Derbyshire County.
We deliver a wide range of initiatives around evidence-based objectives, demonstrating how oral health can often be embedded within existing policies and practices, which impact general health and well being.
Oral health initiatives are targeted in localities where there is a high dental need with a particular focus on children, vulnerable adult groups and older people.
There are two common oral diseases - tooth decay and gum disease. Both can limit an individual’s ability to eat, speak and chew and both are largely preventable. Many of the risk factors associated with poor oral health such as smoking, alcohol misuse and a poor diet are also risk factors for other general health conditions such as heart disease, diabetes and obesity.
There are five key messages to support good oral health:
- Diet – Reduce the frequency and amount of sugary foods and drinks in the diet. A top tip is to keep sweet treats to mealtimes only.
- Toothbrushing – Brush last thing at night - before bed and on one other occasion. Try not to rinse out after brushing as you will wash the fluoride content of the toothpaste away.
- Fluoride – Use a fluoride toothpaste to give your teeth maximum protection. Check that your toothpaste contains at least 1000 parts per million (ppm) of fluoride. This can be seen on the label. As we grow the amount of fluoride needed to protect our teeth changes:
- 0-3yrs—at least 1000ppm (just a smear of paste-the size of a grain of rice)
- 3+yrs – 1350-1500ppm (use a pea sized amount)
- Some people are prescribed an even higher amount of fluoride by their dentist. If you have a prescribed toothpaste, please keep it out of reach of children and do not share it with others.
- Dental Visits – It is important to visit the dentist regularly. Children should have their first visit by the age of one. For help finding an NHS dentist, visit www.nhs.uk.
- Smoking – Smoking increases your risk of gum disease, oral cancers and other chronic diseases. Did you know you are four times more likely to quit smoking with the help of your local stop smoking service? For help quitting contact Stopping smoking - Live Life Better Derbyshire.
For age specific oral health messages and advice click below:
The Derbyshire Picture
- There are significant inequalities in oral health outcomes across Derbyshire, with areas of higher deprivation experiencing significantly higher levels of decay.
- Children living in poverty are more than twice as likely as the general population to have untreated tooth decay
- Tooth decay is the most common reason for hospital admissions in 6 - 10 age group. This comes with risks of anaesthetic and hospital admissions are costly for the NHS, with the average cost of a tooth extraction in hospital for a child aged five and under £836 2
- There is variation by ethnic group. Regionally the prevalence of decay in five year olds is higher for other ethnic background and Asian/ Asian British 3
- The results of the NHS Dental Epidemiology Programme (now PHE DPHIP) survey undertaken during the 2018/19 school year indicate that in Derbyshire 17.1% of children aged five had experience of dental decay and that this was significantly lower than both England 23.4% and the East Midlands 24.7%
- Although the prevalence of tooth decay in Derbyshire has decreased since the last Epidemiology survey in 2018/19 shows inequalities remain within Derbyshire with rates of dental decay experience in five year olds ranging from 23.3% in Chesterfield to 14.1 in North East Derbyshire & 14.9 in Amber Valley.
- No areas in Derbyshire are ranked worse than the East Midlands average for oral health outcomes in children. Chesterfield has worse outcomes than other localities in Derbyshire.(2019) Within the electoral divisions, the highest levels of experience of dental decay are in Staveley
- Access to dentistry was negatively impacted during Covid-19, with dental practices shut until 8 June 2020, and operating at lower capacity once re-opening. In Derbyshire 36% of adults were seen by a dentist in the 24 months up to June 2022 and 45% of children were seen during the same period. Additionally, there has been disruption to long term oral health promotion efforts, and changes to diet.
2 PHE England
3 PHE: Oral health profile: Derbyshire 2020)
4 Derbyshire schools National Dental Epidemiology Programme 2019
5 National Dental Public Health Team; Hospital Episode Statistics: Extractions data, 2015-16 to 2019-20 findings
Barriers to accessing services / barriers to good oral health care
- Availability of dentists who are accepting new NHS patients – and how to find this out
- Availability of appointments
- Not necessarily a priority compared to other health issues
- Dental anxiety - fear of dental treatment – previous experiences
- Location/ travel
- Barriers for some people with SEN/ Neurodiversity
- Language and communication barriers
- Life commitments– no childcare - busy lifestyles there may be a tendency to use emergency services or delay dental treatment
- Perceptions of need – may not feel they need to attend as they believe there is not a need/no pain/no problem
- Health literacy
- Financial cost of dental treatment and oral health resource
Early Years and Oral Health
Giving every child the best start in life is an underlying theme in all aspects of Early Years frameworks. Childhood disadvantage can significantly impact adult health, and behaviours and habits formed early on can continue into adult life. Shockingly, a recent dental health survey of 3 year olds showed that children in Derbyshire already have experience of decayed, missing and filled teeth at this early age.
Evidence based studies have found that children living in areas of deprivation are more likely to:
- Either share or not own a toothbrush
- Not brush regularly
- Brush unsupervised
- Consume sugary drinks and snacks more frequently
- Visit the dentist less frequently.
We also know that prevention of tooth decay is linked to:
- Brushing last thing at night and at least one other occasion
- Supervised brushing by an adult
- Using a pea size amount of toothpaste containing at least 1000ppm of fluoride. For the best control of decay family toothpaste is best.
- Spitting out after brushing and not rinsing.
- Reducing the frequency of sugary foods/drinks – no more than four episodes within each day.
- Children who establish good brushing habits from an early age have fewer problems with tooth decay
The Oral Health Promotion team deliver evidence based training following the guidance below to help early years and school settings set up supervised tooth brushing programmes.
The Early Years Setting provides a learning environment in which children can develop lifelong skills, attitudes, behaviours and knowledge to influence positive oral and health outcomes in later life. Establishing tooth brushing routines within early years settings can easily be linked to the main components of the early year’s curriculum.
Smile4Life is our supervised toothbrushing programme. It is an early year’s intervention offering children the chance to have additional toothbrushing sessions, which help them to develop toothbrushing as a life skill.
We offer this programme to early years settings who provide care to children in areas of high deprivation and where funded two-year-old places are taken up.
If your setting does not meet these criteria, we can offer you discounted rates for toothbrushes and paste and storage racks for you to buy in. Training and ongoing support from our Oral Health Team will be provided free of charge to enable you to set up and deliver a successful preventive oral health intervention for your children.
Register your interest here.
Our Special Smiles Programme involves supervised toothbrushing to help reduce the risk of gum disease and dental decay, promoting healthy outcomes for this target group.
The latest oral health survey done in special schools (PHE 2015) shows:
- Lower levels of tooth decay, but higher incidence of tooth extractions.
- Those with tooth decay have more teeth affected.
- Oral hygiene is poorer amongst children and young people with special needs.
- As with main stream schools, deprivation has an impact on dental decay.
- deprivation is linked to, not brushing, consuming high amounts of sugar and infrequent dental visits.
The Special Smiles Award recognises that children in special schools are particularly vulnerable and require additional support to prevent both gum disease and tooth decay to achieve better oral health. Our programme was awarded recognition at the National Oral Health Awards as an innovitative approach to improving oral health in specialist settings. Each of our 10 special schools are encouraged to appoint an oral health champion and work towards including oral health activities within the school curriculum and taking part in tooth brushing.
We support the delivery of Oral Health promotion within the school curriculum.
Giving every child the best start in life is a key recommendation of the Marmot Review (2010). Childhood disadvantage can significantly impact adult health and behaviours and habits formed early on can continue into adult life. It is important to embed key oral health messages into the school curriculum to demonstrate why looking after the mouth is so important.
Oral Health in The Classroom
NEW Derbyshire Smile4Life Curriculum Resources!
Oral Health Key Stage 1
Key Stage 2
Key Stage 3
NEW Change 4 Life - Keeping our teeth healthy school resources are now available via Change 4 Life website.
NEW Change 4 Life - Childhood nutrition campaign includes a better food scanner app to help families make healthier food and drink swaps. All new school resources are available in hard copy and digital download via PHE resource centre. Register here!
Using the catalogue below complete the resource loan section and email it to the team. All contact details are on the form. Please note that we do not reserve items and generally expect resources to be loaned for a period not exceeding 2 weeks.
Tooth brushing Apps
- British Dental Health Foundation
- Public Health Observatories
- Department for Education
- Derbyshire County Council
- Public Health resource Centre
- Nottingham | Oral Health Promotion
- Oral Health Foundation
- Oral hygiene
- Oral Health: Teaching and Learning Materials (Primary) - Healthy Schools
- Bright Smiles, Bright Futures | Colgate® Professional
- Aquafresh Brush Time Tales - National Schools Partnership
Poor oral health can affect an individual’s ability to eat, speak, chew and socialise. Since the addition of fluoride to toothpaste people now keep their natural teeth for longer and this can mean they need more complex dental care than people who have dentures.
More than half of older adults who live in care homes have tooth decay, compared to 40% of over 75s who do not live in care homes.
People living in care homes are at greater risk of poor oral health because:
- Long-term conditions (including arthritis, Parkinson’s disease and dementia) can make it harder to hold and use a toothbrush, and to go for dental treatment
- Many medicines reduce the amount of saliva produced and leave people with a dry mouth
- They are at higher risk of getting oral infections and ulcerations
- Lack of toothbrushing equipment
- Staff working in the care home may not have received training in delivering mouth care.
- Delivering Better Oral Health (PHE 2017)
- Oral Health in Care Homes (NICE 2017)
- Improving Oral Health For People in Care Homes (NICE 2018)
- Smiling Matters – Oral Health in Care Homes (CQC 2019)
Training, E-Learning and resources
There are a number of national campaigns which allow us to promote oral health and share key messages. Raising awareness helps people to understand how closely oral health is linked to overall health and wellbeing. Promoting positive oral health behaviours at individual, family and population level highlights the importance of being able to eat, speak, chew and to socialise without dental pain or discomfort. We support these oral health campaigns locally:
World Oral Health Day
Every year on March 20th the World Dental Federation's camapign aims to empower people across the world to take control of their oral health. The campaign encourages individuals, schools, professionals and governments to promote oral health in order to reduce the burden of dental disease globally. We promote this within our local communities, sharing the relevant toolkits to education, workplaces, care homes and professional partners for them to get involved. The theme for the next three years is simple:
"Be proud of your mouth". Take care of your mouth and your mouth will take care of you. See the website for more information and resources.
National Smile Month
This runs from mid May to mid June each year. It is an opportunity to promote key messages around diet, toothbrushing and regular dental visitis. There are lots of ways to get involved. We use the campaign to run competitions like crafting a monster mouth, local brushathons and we have also worked with other oral health teams across the East Midlands to produce Miles of Smiles toolkits for early years settings. Take a look at the website for more ionformation and to take part.
Mouth Cancer Action Month
This campaign is run by the Oral Health Foundation every November. The campaign raises awareness around mouth cancer and the importance of being mouthaware. We deliver community engaement sessions to support this within our local community. The oral health team are Be Cancer Safe champions within North Derbyshire. We work together with other partners to have conversations about mouth cancer and encourage people to visit their GP early if they have any unusual changes of the head and neck. For more information and to get involved see the website.